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Severe Sodium Restriction Diet

Severe Sodium Restriction Diet


In a number of severe diseased states, individuals may be extremely sodium sensitive meaning consumption of dietary sodium or sodium containing fluids may cause serious adverse reactions. In these cases a Severe Sodium Restriction Diet may be required which supplies 500 milligrams of sodium per day as compared to the 3,000- 4,000 milligrams per day level recommended by the Dietary Goals Diet.

The Severe Sodium Restricted Diet is used to treat liver failure associated with edema, congestive heart failure or the management of extreme sodium sensitive hypertension. No salt may be added to any food, beverage, or condiment in this diet.

The Severe Sodium Restricted Diet is adequate for all nutrients except iron for females according to the RDA's. Because this diet is very low in sodium, deficiency of sodium could result if inappropriately applied. Salt substitutes containing sodium should not be used unless a nutritionist is consulted.

In diuretic treated individuals, potassium supplementation may be required as reviewed by a doctor or nutritionist.

Significant amounts of sodium may be found in drinking water from municipal sources, chemically softened water or mineral water. In these cases, demineralized water may be required.

Sample Menu

Menu for One Day

1/2 grapefruit
1/2 c puffed wheat
1 egg (poached) or egg substitute
1 c skim milk or milk - 2% fat
1 tsp unsalted margarine or butter
Hot, noncaloric beverage
1 slice low sodium whole wheat bread


1 c unsalted soup, vegetable2 oz sliced turkey breast
2 sicess whole wheat breadSliced lettuce & tomato
2 tsp salt-free mayonnaise4 apricot halves
1 c low sodium tomato juice1/3 c unsalted cooked sweet corn


2 oz broiled halibut1 c brown rice
1/2 c steamed broccoli1 slice whole wheat bread
1 tsp unsalted margarine 1 banana
1 c skim milk or milk - 2% fatHot, noncaloric beverage
2 tsp oil and vinegar dressing1 c salad: romaine, or Boston lettuce; sliced carrot, cucumber, mushroom, bell pepper, celery

Total Calories For The Day: 1,555

Nutrient Content:


Food Exchange List

Bread and Cereal Exchange List: 4 servings/day


Low sodium yeast breadsLow sodium crackers
Unsalted cooked cerealsPotato
Sweet potatoWhole wheat pastas
Enriched pastasBeans (dried)
Green peasLentil

Unsalted popcorn
Quick-bread made with low sodium baking powder
Unsalted prepared cereals such as:
Puffed rice
Puffed wheat
Shredded wheat

Breads, baked goods, or crackers containing salt, baking powder, or baking soda

Other dry cerealsInstant hot cereals
Frozen potatoesPrepared rice or pasta mixtures

Fat Exchange List: as needed; moderation advised


Vegetable oilsUnsalted mayonnaise
Unsalted butterUnsalted nuts
Unsalted margarineUnsalted salad dressing


Regular mayonnaiseCommercial salad dressing
Regular butterBacon
Regular margarineSalted nuts

Fruit Exchange List: 2 or more per day

Fresh, frozen and low-salt canned fruits, both whole and juice, except those noted below

Maraschino cherries
Dried or frozen fruit with salt or sodium added

Meat and Meat Substitute Exchange List: 5 servings/day


Low sodium cheeseLow sodium tuna and salmon
Cottage cheeseUnsalted peanut butter
EggFresh or fresh-frozen meat, poultry, fish, and shellfish

Smoked, cured, salted, or canned meat, fish, poultry, and shellfish
All other cheeses
Salted peanut butter

Milk Exchange List: 2 servings/day


Skim milkMilk - 2% fat
Whole milk - freshYogurt


ButtermilkChocolate milk
Evaporated milkCondensed milk
Malted milkMilk shakes and other milk mixes

Vegetable Exchange List: 2 servings/day

Fresh, frozen or unsalted canned vegetables, both whole or juices, except those noted below


BeetFrozen sweet corn
CarrotGreen peas
CeleryLima bean
KaleSwiss chard
Dandelion greensCanned tomato products with salt
Mustard greensSalted vegetable juices

Miscellaneous Exchange List

Homemade unsalted soups & broths
Low-sodium catsup
Low sodium mustard
Low-sodium chili sauce
Black pepper - ground & other spices


Cream saucesChili sauce
GraviesBarbecue sauce
Soy sauceMonosodium glutamate (MSG)
MustardPrepared or frozen entrees
CatsupCommercial soups and broths

Note: Include 6-8 cups of fluids, such as water, per day.


Alpers, D.H., R.E. Clouse & W.F. Stenson. 1983. Manual of Nutritional Therapeutics. Little, Brown, and Company, Boston. 457 pp.

American Cancer Society. Facts on Prostate Cancer.

Chicago Dietetic Association and the South Suburban Dietetic Association of Cook and Will counties. 1981. Manual of Clinical Dietetics. W. B. Saunders Co., Philadelphia.

Iowa Dietetics Association. 1984. Simplified Diet Manual: with Meal Patterns, 5th ed. Iowa State University Press; Ames, Iowa. 108 pp.